Rives-Stoppa Repair of Incisional Hernias Using PVDF Mesh: A 10-Year Experience of a Dedicated Surgical Team - Abstract
Background: Ventral hernia repair is one of the most common operations in general surgery. However, the procedure can be associated with significant postoperative complications, especially in the case of incisional hernias. The purpose of this study is to investigate the outcomes of PVDF mesh in the Rives-Stoppa repair of incisional hernias.
Methods: This retrospective observational study, based on prospectively collected data, presents data from 115 patients with incisional ventral hernia who underwent elective Rives-Stoppa repair with PVDF mesh (DynaMesh®-CICAT or DynaMesh®-IPOM) between April 2009 and March 2020. The procedure was combined with component separation in 53 (46%) patients. Mean follow-up was 43 months.
Results: Early complications occurred in 10 (8.7%) patients, including 4 (3.5%) hematomas, 3 (2.6%) surgical site infections, 1 (0.9%) haemorrhage, 1 seroma and 1 death. All of these complications occurred in patients treated without component separation, except for one hematoma. 98 patients were included in the long-term followup. Late complications were recorded in 9 (9.2%) patients, including 6 (6.1%) cases of prolonged moderate pain and 3 (3.1%) recurrences. There was no mesh infection or ileus/obstruction. According to the Carolinas Comfort Scale (CCS), the patients’ quality of life was high.
Conclusion: The results obtained with the Rives-Stoppa technique confirm its status as the gold standard for open incisional hernia repair, especially due to its good combination with component separation in complex cases. Anterior and posterior component separation provided similar results. The repair of incisional hernias with PVDF meshes (DynaMesh®-CICAT or DynaMesh®-IPOM) revealed low recurrence and overall low complication rates. Mesh-related complications did not occur during
the follow-up.